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CASE STUDY Joshua Jones

  • CASE STUDY Joshua Jones

Anna (age 35) and Tom (age 36) Jones have an appointment with you for an evaluation of their son, Joshua, who is 5 years old. They bring all their children to the appointment, including Tommie (6 months), Joshua (5), Sally (7), Mari (11), and Janey (15). You quickly recognize that the entire family needs assistance, not just Joshua.

Joshua was recently diagnosed with acute myeloid leukemia, and he is not expected to live more than a few months. He has been withdrawn and irritable, is crying a lot, and has not been interested in playing or doing the things he used to enjoy before his diagnosis. Also since the diagnosis, his siblings have been fighting a lot at home with each other and their parents and refusing to do their chores. Mari and Janey, the two oldest, are refusing to go to school.

In your initial post, answer the following questions from your perspective as their psychiatric nurse practitioner.

Based on Joshua’s presentation, how would you relate his developmental milestones to his clinical presentation and perception of death and dying? When providing grief therapy, what information would you provide Joshua and his parents regarding Joshua’s perception of his terminal illness?
Select one of the Jones’ children (except Joshua) and identify the normal developmental milestones you would expect based on their current age. Identify an age-appropriate national or community resource related to grief or a sibling with cancer and explain the benefit of the resource you provided.
What, if any, cultural considerations should you apply when working with the Jones family?

Sample Solution

Geopolitical and military implications The current deadlock in Israeli-Palestinian relations is not the result of a refusal to compromise between the two authorities – on the contrary, the two entities have tried to reach a consensus on various occasions. The central issue is the suspicion that the two sides have signed bilateral agreements on various occasions that have proved infallible and difficult to respect. Ultimately, this adversity of trust-based bargaining pushes Israel towards uni- versality and the Palestinians towards violence. In this context, the bilateral relations between the two sides were marked by: 1. The initiation of superficial bargaining efforts, which have proved to be impossible to respect. The main aspect that permanently amplifies these military confrontations is the existence of an impressive military arsenal that can be used anytime. 2. The irreconcilability between the two authorities was amplified by the 2005 Hamas electoral gain, which in fact meant the uprooting of the organization’s terrorist actions based on popular support. 3. One main cause of the failure of the agreements signed between the two parties is that the penalties stipulated for the reopening of the armed conflict were not respected and the international community had a pale reaction. 4. Apart from the security and geopolitical aspects, the impossibility of reconciling the two sides is also strongly supported by ethnic, social and especially religious differences. Conclusions and solutions Knowing the complexity of the situation, the tensions in the area as well as the political, religious and social implications, as the author of this article, provide for the following situations: 1. Concluding an agreement aimed at the immediate cessation of violence. – Establishing a permanent peace. This is an issue that would be of interest to both parties – Hamas would have the opportunity to administer the territory under its authority and to settle accounts with Al Fatah, while Israel would be able to handle the Iranian issue. Such bargaining attempts have taken place since the Clinton administration in 2000, the Taba Negotiations in 2001 or the 2003 Geneva Initiative. A resumption of these diplomatic discussions is hindered by Hamas for two reasons – 1. This peace would mean recognizing Israel’s legitimacy over the confluence territories of the two sides. 2. Hamas would lose the conflict initiative that provided its popular support, losing ground to Al Fatah rivals. 2. Israel’s withdrawal from the West Bank and the presence of delegated troo
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